Blood‐based Alzheimer's disease biomarkers and cognitive trajectories in older people with HIV with undetectable viral loads

作者：Akarin Hiransuthikul, Poosanu Thanapornsangsuth, Watayuth Luechaipanit, Thanaporn Haethaisong, Sasiwimol Ubolyam, Tanakorn Apornpong, Win Min Han, Stephen J. Kerr, Anchalee Avihingsanon, HIV‐NAT 006 and 207 study team · 发表于：Alzheimer s & Dementia · 年份：2026 · DOI：10.1002/alz.71101 · 被引用次数：4 · 研究领域：Dementia and Cognitive Impairment Research、HIV Research and Treatment、Alzheimer's disease research and treatments

INTRODUCTION: Cognitive impairment among people with HIV (PWH) remains common, yet underlying mechanisms remain unclear. Alzheimer's disease (AD) is the leading cause of dementia, and blood-based biomarkers offer a promising diagnostic alternative. We evaluated phosphorylated-tau 217 (p-tau217), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) as predictors of cognitive decline among virologically suppressed older PWH. METHODS: Thai PWH aged ≥50 years with plasma viral loads <50 copies/mL completed the Montreal Cognitive Assessment (MoCA) at baseline (2015-2017) and a follow-up visit (2021-2024). Associations between each biomarker and cognitive trajectories were assessed using multivariate mixed-effects models. RESULTS: Among 255 participants followed for a median of 5.9 years, those in Q4 of p-tau217 and GFAP had greater MoCA decline than Q1-3 (p-tau217: -3.3 vs. -1.4, p-interaction = 0.02; GFAP: -2.9 vs. -1.3, p-interaction = 0.03). DISCUSSION: Elevated p-tau217 and GFAP predict cognitive decline in PWH, underscoring AD and inflammatory biomarker relevance.